Editor-in-Chief Ufuk Demirkılıç Frequency Quarterly Abbreviation Turk J Vasc Surg Publisher Turkish National Vascular and Endovascular Surgery Society ISSN 2667-4947 E-ISSN 2667-5080

Turkish Journal of Vascular Surgery 2021 , Vol 30 , Issue 1
The effect of anesthesia technique in carotid endarterectomy: Regional versus general anesthesia
Ali İhsan Hasde1, Çağdaş Baran1, Evren Özçınar1, Haluk Çağlar Karakaya1, Ahmet Onat Bermede2, Mustafa Serkan Durdu1, Levent Yazıcıoğlu1, Bülent Kaya1
1Department of Cardiovascular Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
2Department of Anesthesiology and Reanimation, Ankara University Faculty of Medicine, Ankara, Turkey
DOI : 10.9739/tjvs.2021.845 Objectives: The aim of this study was to evaluate the impact of anesthesia techniques on perioperative outcomes in patients undergoing carotid endarterectomy.

Patients and methods: This retrospective study included a total of 264 patients (164 males, 100 females; mean age 67.2 years; range, 58 to 84 years) who underwent carotid endarterectomy in our clinic between April 2016 and October 2019. The patients were divided into two groups according to the type of anesthesia as those undergoing regional anesthesia (RA group, n=128) and those undergoing general anesthesia (GA group, n=136). Pre-, intra-, and postoperative data of the patients were evaluated.

Results: The incidence of myocardial infarction and cerebral complications was similar between the groups (1.6% in RA group vs. 1.5% in GA group, p=1.00; 2.3% in RA group vs. 2.2% in GA group, p=1.00, respectively). The mean total operating time was significantly shorter in the RA group (92.5±7.7 min vs. 97.1±7.2 min, respectively; p<0.0001). The mean time to first postoperative analgesia requirement was significantly shorter in the GA group (193.9±20.8 min vs. 114.5±17.1 min, respectively; p<0.0001). The intraoperative hypotension rates were higher in the GA group (13.3% vs. 31.6%, respectively; p=0.0004), while the intraoperative hypertension rates were higher in the RA group (41.4% vs. 26.5%, p=0.0132). Postoperative hypotension (1.6% vs. 8.1%, respectively; p=0.0201), hypertension (26.6% vs. 69.1%, respectively; p<0.0001), and coexistence of hypotension and hypertension rates (2.3% vs. 9.6%, respectively; p=0.0185) were higher in the GA group compared to the RA group.

Conclusion: Our study results demonstrate that anesthesia techniques do not substantially affect cerebral complications, postoperative myocardial infarction, and mortality in carotid surgery. Furthermore, RA provides better hemodynamic stability, less pulmonary complications, less analgesic use, and shorter length of hospital stay. Keywords : Carotid endarterectomy, general anesthesia, regional anesthesia

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